Trauma can be treated, but not erased

'Scientists at MIT have identified (in mice) the gene responsible for memory extinction, which could eventually lead to important developments in the ­treatment of post-traumatic stress disorder.' Photograph: 237/Ocean/Corbis

Thursday 26 September 2013 01.30 EDT
First published on Thursday 26 September 2013 01.30 EDT

I am often wary of attempts to use mice as a way of predicting human responses (whether biological or psychological), but this time I was drawn in. "The Real Eternal Sunshine of the Spotless Mind," squealed the headline. "Gene discovery paves the way for a pill to erase your most painful memories." This ostensibly silly story actually contained important research: scientists at MIT have identified (in mice) the gene responsible for memory extinction, which could eventually lead to important developments in the treatment of post-traumatic stress disorder – a condition that, according to the NHS, affects 5% of men and 10% of women over the course of their lives.

I am one of those women. In September 2010 I was subjected to a random attack, during which I was cornered by three men, one of whom strangled me. I was lucky to get away alive, but I was left profoundly affected by what happened. But it isn't just me – traumatised people walk among us, unseen. There's a feeling that friends, family, members of the public, or even the system at large can never truly understand. Whether you're a veteran, a victim of abuse, or a refugee, the condition itself is profoundly isolating.

While science is not quite at the stage where it can erase memories of our ex-partners, the story did make me wonder how I would respond if faced with a pill or a procedure that could make the memory of the bad thing that happened go away for ever. Would I do it?

As recent speculation as to whether Aaron Alexis, the Washington navy yard gunman, was suffering from PTSD illustrates, the effects of trauma are little understood. Studies have shown how difficult it is to link the disorder and extreme violence without resorting to the anecdotal, as many studies rely on war veterans responding to questionnaires. There is little doubt that PTSD increases feelings of anger and aggression (veterans with the disorder are two to three times more likely to be violent towards wives or girlfriends), but the jump to murder is a big one to make without further research.

As far as my own condition, yes, there were times when I felt like killing people, but there were many, many more times where I felt like people were trying to kill me. One person had tried, but in my confused and traumatised brain, there were more where he came from. Like many trauma victims, I was constantly on high alert but, naturally, other people just thought I was mad.

Fury, paranoia, hypervigilance, overreaction to a perceived threat – all are common in a traumatised person. The psychologist who helped me to get better characterised the condition thus: imagine your memories are a conveyor belt of cardboard boxes heading towards a final point, where they are processed. But if something life-threatening disrupts that process, the box memories get stuck, trapped in the amygdala, that bit of the brain that triggers your fight or flight survival impulse. The amygdala knows no sense of past or present, and so, when faced with a perceived threat, it responds how it sees fit, unbeholden to logic, in the form of blind panic.

This is, of course, a very basic way of explaining an extremely complicated condition, but it certainly helped me. When faced with irrational outbursts of anger, flashbacks, paranoia, sleeplessness, knowing this was a source of comfort. For months I was terrified that the tube was crawling with terrorists intent on blowing me up. "What's the worst that can happen?" my therapist would ask, appealing to my rational self. "What's the worst?"

I was treated using trauma-focused cognitive behavioural therapy, provided by the NHS. I was fortunate that there wasn't too long a waiting list; others aren't so lucky. A survey by the We Need To Talk coalition found that one in five of those with mental health problems were waiting more than a year for referral, but studies have shown that those with PTSD should be given therapy within three months.

Part of the treatment involves reliving – an emotional and arduous process where every moment of the event is recounted and expanded upon. I was surprised by the things I remembered, how the patchwork quilt of that evening became increasingly more detailed. It made me wonder about those legal cases involving victims, fleeing conflict zones and seeking asylum, that hang on the consistency of their evidence. What if, instead of sanctuary, a guilty verdict, and someone saying "I believe you", I had been told that my fractured, confused story didn't add up? If you'd been through an experience like that, wouldn't you take the magic pill?

I don't know how many people there are in this country walking the streets addled by trauma, but I know that they need to be better looked after. And I wonder if the research will ever come to anything. Just how much horror, after all, can a mouse experience?